Pharmacology: The Ans And Antipasmodic Drug

Front 1

classification of
Bethanechol (Urecholine)

Back 1

Parasympathomimetics (Cholinergics)

Front 2

Mechanism of
Bethanechol (Urecholine)

Back 2

a synthetic acetylcholine that acts to mimic the parasympathetic response through the Muscarinic Receptors.

Front 3

Major side/Adverse Effects of
Bethanechol (Urecholine)

Back 3

1. arrhythmias
2. burping
3. bladder urgency
4. abdominal cramps
5. headache
6. hypotension.

Hint 3

aabbhh

Front 4

Nursing implication (dosage) for
Bethanechol (Urecholine)

Back 4

Normal adult dose:
PO 10-50mg po bid-qid
SC 2.5-5mg tid or qid prn

Front 5

Indications (usage) of
Bethanechol(Urecholine)

Back 5

Treat unobstructed urinary retention and paralytic illus.

Front 6

classification of
Neostigmine (Prostimin)

Back 6

Parasympathomimetics (Cholinergics)

Front 7

Mechanism of
Neostigmine (Prostimin)

Back 7

Mimic the action of acetylcholine and thereby Activation of nicotinic neuromuscular receptor causes structural changes that allows potassium and sodium ions to alter their concentration- this stimulate skeletal muscle contraction.

Front 8

Major side/Adverse Effects of
Neostigmine (Prostimin)

Back 8

1. arrhythmias
2. burping
3. bladder urgency
4. abdominal cramps
5. headache
6. hypotension.

Hint 8

same as bethanechol (Urecholine)

Front 9

Indications (usage) of
Neostigmine (Prostimin)

Back 9

Myasthenia gravis and help relieve urinary retension.

Front 10

classification of
Atropine sulfate

Back 10

Parasympatholytics (Anticholinergics)

Front 11

Mechanism of
Atropine sulfate

Back 11

act by blocking acetylcholine receptors mainly muscarinics. Crosses the BBB to become CNS stimulant.

Front 12

Major side/Adverse Effects and Contraindications of
Atropine sulfate

Back 12

Adverse effects: tachycardia associated larger dose.
Contraindications:
1. clients undergoing open heart surgery.
2. Glaucoma
3. BPH

Front 13

Nursing implication (dosage)for
Atropine sulfate

Back 13

oral 0.3 to 1.2 mg q 4-6 hours.
parenteral 0.4 to 0.6 mg q 4-6 hours.

Front 14

Indications (usage) of
Atropine sulfate

Back 14

1. Bradyarrhythmias
2. sinus bradycardiaand
3. relieves bronchospasm.
2. Treatment of GI disoders (such as IBS and spastic biliary tract disorders)
4. Parkinson's (decrease tremors)
5. preanesthetic agent.

Front 15

Classification of
epinephrine (Adrenalin)

Back 15

Sympathomimetics (Adrenergics)
Adrenergic Agonist

Front 16

Mechanism of
epinephrine (Adrenalin)

Back 16

Mimic the effect of sympathetic response. stimulates alpha and beta receptors of the heart, smooth muscles, bronchi and blood vessels.

Front 17

Major Side/Adverse Effects of
epinephrine (Adrenalin)

Back 17

1. Increase nervousness
2. restlessness
3. insomnia
4. tachycardia
5. increased blood pressure
6. sweating
7. tremors
8. nausea
9. Vomiting
10. pallor.

Hint 17

there're 10

Front 18

Implication Usage of
epinephrine (Adrenalin)

Back 18

1. used in treatment of anaphylactic shock
2. also bronchodilates
3. use as adjunct with local anesthetics because it reduces circulation to site (less bleeding)and slows vascular absorption of local anesthetic (thereby prolongs duration of action).

Front 19

Nursing Implication/ Dosage for
epinephrine (Adrenalin)

Back 19

1. Not giving orally- will not achieve serum levels
2. Well absorbed following IM or SC
3. Rapid onset of action
a) 3 to 5 minutes after inhalations
b) 6 to 15 minutes after SC
c) In cardiac arrest dose may be repeated every 5-20 minutes.

Front 20

Classification of
Propanolol (Inderol)

Back 20

-Sympatholytics
(Adrenergic Blockers)
-Beta adrenergic blocking agent (beta blocker)

Front 21

Mechanism of
Propanolol (Inderol)

Back 21

Beta blockers compete with catecholamines at the receptor sites, this inhibiting the receptors.

Front 22

Major Side/Adverse Effects of
Propanolol (Inderol)

Back 22

Drowsiness, difficulty sleeping, weakness, anxiety, Nasal congestion, abdominal distress, dizziness, Bradycardia, Vomiting, Depression, Cold hands & feet, difficulty breathing.

Front 23

Implication Usage of
Propanolol (Inderol)

Back 23

1. Arrhythmias,
2. MI,
3. Angina pectoris,
4. Hypertension

Hint 23

all have to do with the heart

Front 24

Nursing Implication/ Dosage for
Propanolol (Inderol)

Back 24

1. If apical pulse below 60. hold rx
2. cheek BP
3. Withdraw from Rx slowly
4. No OTC especially decongestants, cough or cold medicines.
5. mask signs of hypoglycemia

Front 25

Neurotransmitter of the Sympathetic System

Back 25

catacholamines:
1. Epinephrine
2. Norepinephnne
3. Dopamine

Front 26

Receptors of the Sympathetic nervous system

Back 26

Alpha(1&2) and Beta (1&2)Receptors

Front 27

Where's alpha 1 receptors found?

Back 27

Found primarily in the smooth muscle tissue of the peripheral blood vessels and in the sphincters of the gastrointestinal and genitourinary tracts.

Front 28

Where's alpha 2 receptors found?

Back 28

Located on the presynaptic neuron

Front 29

What is (are) the action(s) of alpha 1 receptor when stimulated.

Back 29

- When stimulated, Alpha1 receptor causes the smooth muscle to contract.
- Implication in relieving severe hypotension?
- Implication in relieving nasal congestion?
- Injection of alpha1 stimulant such as epinephrine (Adrenalin) with another drug (e.g. local anesthetic) causes local constriction of blood vessels in the area and prevent rapid diffusion of the drug away from the injection site.

Front 30

What is (are) the action(s) of alpha 2 receptor when stimulated.

Back 30

- Act as a "controllers" of neurotransmitter release by the presynaptic neuron.
- Sense the concentration of the neurotransmitter in the synaptic space, when its too much it stimulates the decrease of neurotransmitter from the presynaptic neuron.

Front 31

Where's beta 1 receptors found?

Back 31

Located in the muscles of the heart.
Located also in the fatty tissue

Front 32

Where's beta 2 receptors found?

Back 32

1. Located primary in the bronchial smooth muscle in the walls of blood vessels
2. located in skeletal muscle, the brain, and the heart.

Front 33

What is (are) the action(s) of beta 1 receptor when stimulated.

Back 33

1. It stimulates more forceful heart muscle contraction and more rapid heart rate. Indications for depress cardiac function
2. Stimulation of beta1 promotes the breakdown of stored fat to fatty acids, which the body can use as an energy source.

Front 34

What is (are) the action(s) of beta 2 receptor when stimulated.

Back 34

1. Stimulation of beta2 result in muscle relaxation, thereby increases the diameter of air channels and promoting improved gas exchange.
2. Implication in treatment of bronchial asthma or other condition marked by dyspnea.

Front 35

What is the Neurotransmiter of parasympathetic (Cholinergic) nervous system.

Back 35

acetylcholine

Front 36

What are the two types of acetylcholine receptors

Back 36

1. muscarinic receptor
2. nicotinic receptor

Front 37

What can nicotinic neuromuscular receptor be stimulated by?

Back 37

alkaloid nicotine

Front 38

What can nicotinic neuromuscular receptor be blocked by?

Back 38

curare derivatives

Front 39

What can muscarinic receptors be blocked by?

Back 39

1. atropine
2. belldona derivative
3. scopolamine.

Front 40

Classification of
Adrenalin (Epinephrine)

Back 40

Adrenergic Agonist

Front 41

Primary action of
Adrenalin (Epinephrine)

Back 41

Primary action: to stimulate the heart by increasing heart rate, force of contraction, and cardiac output.

Front 42

Usage of
Adrenalin (Epinephrine)

Back 42

1. For symptomatic treatment of bronchial asthma and COPD.
2. For symptomatic relief of acute hypersensitivity reactions. Emergency treatment of anaphylactic shock. Pulmonary congestion is also alleviated by the constriction of mucosal blood vessels.
3. use as adjunct with local anesthetics because it reduces circulation to site (less bleeding); slow vascular absorption of local anesthetic, prolongs duration of action and reducing the risk of anesthetic toxicity.
4. As a hemostatic agent to control superficial bleeding from arterioles and capillaries in the skin, mucous membrane, or other tissue.
5. In ocular surgery to control bleeding, induce mydriasis and conjunctivas decongestion, and decrease intraocular pressure.
6. to treat cardiac arrest o cardiac standstill.

Front 43

Main SE of
Adrenalin (Epinephrine)

Back 43

Increase nervousness, restlessness, insomnia, tachycardia, tremors, sweating, increased blood pressure, nausea, vomiting, pallor, dry mouth and throat, headaches, and flushing of the face and skin.

Front 44

Classification of
Norepinephrine (Levophed)

Back 44

norepinephrine is a direct-acting sympathomimetic amine identical to the catecholamine synthesized in the postganglionic nerve endings of the sympathetic nervous system.

Front 45

effects of
Norepinephrine (Levophed)

Back 45

1. constrict blood vessels of the skin and mucous membrane.
2. reduce blood flow to the kidney and other visceral organ.
3. increase the force of myocardial contraction, resulting in an increase in cardiac output.
4. Elevate both systolic and diastolic BP.

Front 46

Usage of
Norepinephrine (Levophed)

Back 46

1. selectively used to restore BP.
2. cardiac arrest
3. profound hypotension

Front 47

Side Effects/ Adverse reactions of
Norepinephrine (Levophed)

Back 47

1. Anxiety
2. Headache
3. Insomnia
4. Pallor
5. Dizziness
6. Pounding HR
7. Tremors
8. Hyperthyroid gland in the neck.

Front 48

Classification of
Dopamine hydrochloride (Intropin)

Back 48

Dopamine is a catecholamine that occurs as a precursor of norepinephrine. It acts both directly and indirectly by releasing norepinephrine.

Front 49

effects of
Dopamine hydrochloride (Intropin)

Back 49

Depends on the amount of drug administered.
1. Low dosages (0.5 to 2 ug/kg/min)
a) vasodilation on of the renal and mesenteric arteries.
b) increase urine and sodium excretion.
c) Helps present kidney failure secondary to shock.
2. low to moderate dosage (2 to 10 ug/kg/min)
a) increase cordiac output
b) Increase systolic and pulse pressure.
3. higher doses & dopamine (10 ug/kg/min)
a) increase peripheral resistance
b) Reduce urinary output
c) Vasoconstriction

Front 50

Usage of
Dopamine hydrochloride (Intropin)

Back 50

1. Use in treatment of circulatory shock and refractory heart failure
2. Used to correct homodynamic imbalances associated with shock syndrome caused by myocardial infarction, trauma, endotoxin septicemia, open heart surgery, renal failure, and chronic cardiac decompensation (as in CHF)

Front 51

side effect/ Adverse reaction
Dopamine hydrochloride (Intropin)

Back 51

1. headaches
2. Nausea
3. Vomiting
4. Angina
5. respiratory difficulties
6. decrease blood pressure